NPIMap

Organization Active NPI

Palestine Principal Healthcare Limited Partnership

Doing business as Palestine Regional Medical Center

  • General Acute Care Hospital
  • Palestine, TX
National Provider Identifier
1164510673
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
PALESTINE PRINCIPAL HEALTHCARE LIMITED PARTNERSHIP
Doing business as
Palestine Regional Medical Center
Practice address
2900 S Loop 256
Palestine, TX 75801-6958
Phone
(903) 731-1000
Fax
(903) 731-2236
NPI assigned
Oct 10, 2006
Last updated
Jun 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Johnetta Traylor
Title
Administrator
Phone
(502) 596-6063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

2900 S Loop 256
Palestine, TX 75801-6958

Mailing address

680 S 4TH St # KH3
Louisville, KY 40202-2407
Phone (502) 596-6063

Other names 1

  • Palestine Regional Medical Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address palestine@yourcarecommunity.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030422000028 TX Part A Provider - Hospital 7214844976 1 other NPI on this enrollment
Practice locations: Palestine, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164510673. Details of each certification follow.

Hospital certification: CCN 450747

Legal name
PALESTINE PRINCIPAL HEALTHCARE LIMITED PARTNERSHIP
Doing business as
PALESTINE REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Dec 16, 1987
Last certification
Mar 21, 2024
Beds
161 (71 certified)
Ownership / control type
Private (for profit)
Most recent change of ownership
Oct 1, 1999 (1 total)
Organization structure
OtherProprietary
Incorporated
Jul 16, 1996 in TX
Enrollment address
2900 S Loop 256
Palestine Regional Medical Center
Palestine, TX 75801-6958
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Palestine Regional Medical CenterCCN 450747 · All quality measures
Overall star rating
1 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Grapeland Rural Health5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kindred Healthcare Operating LLC Organization, Louisville, KY LLC, For-profit, Chain home office Operational/Managerial Control Dec 23, 2021
Palestine-Principal G P Inc Organization, Louisville, KY Corporation, Holding company, For-profit General Partnership Interest Aug 16, 2005
Jacquelyn Joy Davis Individual Contracted Managing EmployeeChain Home Office Administrator Dec 16, 2023
Scott Graeser Individual Corporate OfficerVice President, Treasurer Aug 19, 2022
Dana M Rock Individual Corporate OfficerAssistant Administrator Dec 9, 2024
Johnetta M Traylor Individual Corporate OfficerAdministrator Dec 9, 2024
Russell Pigg Individual Corporate OfficerPresident Mar 17, 2025
Knight Health Holdings LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 100%
Bernard Pogue Individual Contracted Managing EmployeeFacility Cfo Nov 23, 2023
Michael Joseph Bean Individual Corporate OfficerVice President, Tax Jan 21, 2022
Knight Healthcare New-B, LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Dec 23, 2021
Knight Health II, LLC Organization, Louisville, KY LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2021 100%
Alan Wenk Individual Corporate OfficerChief Financial Officer Mar 17, 2025

Facilities with the same owner 97

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 97

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

Affiliated clinicians 118

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 118

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749600000000",
    "number": "1164510673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 S 4TH ST # KH3",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022407",
            "telephone_number": "502-596-6063",
            "fax_number": "502-212-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 S LOOP 256",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758016958",
            "telephone_number": "903-731-1000",
            "fax_number": "903-731-2236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALESTINE PRINCIPAL HEALTHCARE LIMITED PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A",
        "authorized_official_last_name": "TRAYLOR",
        "authorized_official_first_name": "JOHNETTA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "502-596-6063"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "palestine@yourcarecommunity.org",
            "affiliation": "N",
            "address_1": "2900 S Loop 256",
            "city": "Palestine",
            "state": "TX",
            "country_code": "US",
            "postal_code": "758016958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Palestine Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Palestine Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palestine, TX

Sources for this page

Verify at the official NPI Registry.